From the President & CEO...
Contemplating our future

Chris Queram, President and CEO

Recently, the WCHQ Board was presented with an unexpected opportunity to reconfirm and reassess its strategic direction with new Board Chair, Dr. John Weigelt, at the helm. The Board typically holds its annual strategic planning retreat in the fall, but scheduled another session this past May following John’s assumption of the position of Chair in March. This timing proved to be quite fortuitous, given the current dynamic healthcare environment resulting from the impact of the plethora of recent state and national changes.

As we’ve discussed in prior issues of this newsletter, the “HITECH” provisions of the American Reinvestment and Recovery Act (ARRA) are the proximate cause for the formation of the state’s WIRED for Health Board (see “Wisconsin’s health information exchange plan development underway” in this issue). This effort, as well as the soon-to-be-released regulations that relate to “meaningful use” of health information technology and exchange, have all created opportunities and implications for WCHQ. Additionally, the national Patient Protection and Affordable Care Act (PPACA) outlines a comprehensive set of provisions that collectively and individually provide significant opportunity for WCHQ to build on its leadership role in the areas of performance measurement and reporting.

Within the context of a larger organizational strategy session, the Board identified areas where mandated healthcare changes and WCHQ’s areas of expertise (and those of other statewide organizations) intersect. WCHQ’s experience in performance measure development, stakeholder collaboration, and data collection and reporting will likely prove valuable as state and national healthcare reform plans are implemented.

Filling measurement gaps
As part of a national strategy to focus efforts to improve healthcare delivery, the PPACA calls on the Secretary of Health and Human Services to formulate policy decisions – within the relatively short period of one year or less – that will impact performance measurement. To begin, the Secretary is required to send a national strategy for performance measurement, reporting and improvement to Congress by January of 2011.

In all probability, the Secretary will incorporate the important work of the National Priorities Partnership – administered by the National Quality Forum (NQF) – to set national priorities for performance measurement and improvement and identify gaps in quality measurement in areas like care coordination, overuse, and efficiency measures. Where gaps are determined to exist, funding will be made available for the development of robust and clinically-relevant measures – representing a possible opportunity to capitalize on WCHQ’s experience with performance measure development.

Stakeholder collaboration
The concept of a “consultative partnership” is embodied in the national healthcare reform legislation. This approach involves bringing stakeholders together from various perspectives to identify and select performance measures that will be used for public reporting, payment reform, quality improvement, and consumer engagement. This concept is easily transferable to Wisconsin and represents a significant opportunity for WCHQ to leverage its subject matter expertise by playing a leadership role in bringing Wisconsin stakeholders together to forge consensus on a core set of measures for similar uses.

Data collection and physician performance reporting
The PPACA contains provisions that allow the Secretary to issue grants to foster the development of creative and scalable tools for collecting and storing data for performance measurement. The Act also institutionalizes the Physician Quality Reporting Initiative (PQRI) and links the program to the “Maintenance of Certification” (MOC) programs of the medical specialty boards, thus creating a powerful incentive for all physicians to engage in performance measurement and reporting. This may create an opportunity for WCHQ to position its Repository-based data Submission (RBS) tool – which is a CMS-approved PQRI registry – for use by an even larger group of physicians.

Final thoughts
Another important concept running throughout the Board’s strategy session was the question of how best to leverage the assets, capabilities, and infrastructure that groups such as WCHQ, the Wisconsin Hospital Association, the Wisconsin Medical Society, the Wisconsin Health Information Organization, and others have worked so hard to build these past many years. At the same time, it was acknowledged that the current trajectory of performance measurement and improvement may not be sustainable, given the increasing demands of federal, state, and local initiatives. In that spirit, the Board noted that the strong collaborative relationships that exist among these organizations set the stage for discussions on ways to minimize duplication, maximize synergy and accelerate the rate at which we’re reporting measures, improving care and reducing costs.

In summary, the ARRA and PPACA have firmly established performance measurement as a fundamental activity for all types of providers, not just physician groups and hospitals. The question is, given the process of establishing and implementing regulation to make healthcare reform real, what are the opportunities for WCHQ? This question and the other areas mentioned above provided the grist for a very robust and engaged strategy session. We are now in the process of sorting out the strategic goals and activities that will guide our future path. As always, we encourage your questions and feedback as we move forward with this exciting and very important process. I can be reached at 608-826-6837 or cqueram@wchq.com.

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